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Nurses Review Recent Advances of Fetal Surgery for Spina Bifida

August 13, 2012 —Thirty years ago the idea of performing fetal surgery seemed more like science fiction than reality. Today, however, highly sophisticated surgical teams regularly repair spina bifida and other birth defects before birth, and fetal therapy is recognized as one of the most promising fields in pediatric medicine.

Spina bifida is the most common birth defect of the central nervous system, affecting about 1,500 babies born each year in the United States. In 2011, research co-led by The Children’s Hospital of Philadelphia (CHOP) and published in the New England Journal of Medicine, showed that performing surgery in the womb, months before birth, can substantially improve outcomes, such as mobility, for children with this common, disabling birth defect of the spine.

In a new article in the August 2012 issue of the AORN Journal, published by the Association of periOperative Registered Nurses, nurses from CHOP’s Center for Fetal Diagnosis and Treatment review the history of fetal surgery for spina bifida from inception to current practice.

CHOP nurses help advance field of fetal medicine

“Our Center’s multidisciplinary team has the world’s greatest amount of experience performing fetal surgery and as a result, CHOP nurses have had a great opportunity to help advance the field of fetal medicine,” said Susan M. Scully, BSN, RN, CNOR. “Specifically, as participants in the landmark Management of Myelomeningocele Study (MOMS), CHOP nurses contributed to making fetal surgery for spina bifida a standard-of-care option for families.”

In their article, “Fetal Myelomeningocele Repair: A New Standard of Care,” Scully and her co-authors, Maureen Mallon, MBA, BSN, RN, CNOR, Joy C. Kerr, BSN, CNOR, and Allison Ludzia-DeAngelis BSN, RN, provide an overview of the field of fetal surgery, the rationale to prenatally repair spina bifida, the landmark MOMS trial, CHOP’s fetal surgery program and the important role perioperative nurses have played in this pioneering treatment.

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About the Center for Fetal Diagnosis and Treatment at CHOP

The Center for Fetal Diagnosis and Treatment at The Children’s Hospital of Philadelphia is an internationally recognized leader in fetal surgery and fetal care. One of the only programs of its kind in the world, it offers a comprehensive breadth of services, including fetal therapy, to support patients from prenatal evaluation through delivery, postnatal care, and long-term follow-up.

Established in 1995, the Center has welcomed more than 12,000 expectant parents and received referrals from all 50 states and more than 50 countries. Its multidisciplinary team brings decades of experience to the care and treatment of the fetus and the expectant mother.

The Center has performed more than 900 fetal surgeries, including complex open procedures for birth defects such as spina bifida; less invasive fetoscopic or ultrasound-guided surgeries for conditions such as twin-twin transfusion syndrome; and specialized coordinated delivery approaches for babies that require surgical intervention while still on maternal-placental life support (EXIT delivery).